Formulary guidance and transparency from P&T to point of care

Trends that Matter for Market Access in Trending Classes

Posted by Matt Breese on Jan 13, 2016

Find me on:

According to a recent survey from IMS, market access is the number one issue for pharmaceutical manufacturers and other healthcare stakeholders. Understanding shifts in market access, with new drugs entering the market each year across major therapeutic areas, is a crucial task for pharma. Depending on the market basket, the balance between pharmacy benefit, medical benefit and reimbursement restrictions significantly affects prescribing at the point of care and, ultimately, the revenue of a product. Here’s a look at some key metrics from the past three months on trending therapeutic areas:

PCSK9 Inhibitors: Health exchange and medicare formularies restrict access to products for a significant portion of U.S. lives, while commercial and managed medicaid channels cover products for over two-thirds of lives. Read more PCSK9 trends here.




Diabetes: Utilization management from top payers shows that payers controlling 40% of pharmacy lives require a step therapy regimen. However, restricted lives vary by diabetes sub-classes, including SGLT2 & GLP-1 inhibitors, combination agents and DPP-4 inhibitors.  Read more Diabetes trends here.



DMARDs: A review of market access across rheumatoid arthritis, psoriasis, Crohn's and psoriatic arthritis reveals the variance between leading brands and the remaining product median for top health plans. Read more Disease Modifying Agents trends here.



Hemophilia: Although individual product access varies slightly, this graphic represents the average drug's market access. Products process exclusively through pharmacy benefit for roughly half of U.S. covered lives. Read more Hemophilia trends here.



Multiple Sclerosis: All brands in the class face restrictions on some plans, even when preferred. A national market access snapshot across top plans reveals that Copaxone holds a slight advantage against other leading brands. Read more Multiple Sclerosis trends here.


Subscribe to email updates on the right to check out weekly market access review for top therapeutic areas.

Follow MMIT on Twitter

Topics: Industry Trends, Market Access